The University of Michigan Comprehensive Cancer Center (UMCCC) has taken on a leadership role in developing precision medicine approaches for oncology. In April of 2011, the MI-ONCOSEQ clinical sequencing program was established, which prospectively enrolls patients with advanced cancers for comprehensive mutational analysis using an integrattve sequencing approach. Since establishment of this protocol, over 250 adults and 40 children with cancer have been sequenced with return of results through an Institutionally sanctioned